Drug & supplement interaction

Boswellia Serrata + Effient

Effient brand name: Prasugrel.

Moderate Interaction
Medically reviewed by · Updated September 2026
The bottom line Moderate

Effient falls into 3 drug categories that Boswellia Serrata can interact with; the most serious is rated moderate. Theoretically, Boswellia serrata might increase the levels of CYP2C19 substrates.

Read the full interaction report
SeverityModerate
LikelihoodPossible
Interactions3
EvidenceD
What do Severity, Likelihood & Evidence mean?
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Interaction report

Boswellia Serrata and Effient

These two interact in 3 distinct ways. Each one is explained separately below.

Why Are There 3 Interactions?

Boswellia Serrata interacts with whole categories of medication. Effient falls into 3 of those categories, so it can interact with Boswellia Serrata in 3 different ways. We’ve listed each one below — your overall risk is driven by the most serious of them (Moderate).

Moderate

CYTOCHROME P450 2C19 (CYP2C19) SUBSTRATES

1 of 3

Why this applies to Effient

Effient falls under CYTOCHROME P450 2C19 (CYP2C19) SUBSTRATES — the group Boswellia Serrata interacts with.

Theoretically, Boswellia serrata might increase the levels of CYP2C19 substrates.
In vitro research shows that Boswellia serrata gum resin inhibits CYP2C19 enzymes.
Severity Moderate Likelihood Possible Evidence D

Interaction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists.

Dr. Brian Staiger, PharmD, BCPS
Dr. Brian Staiger explains PharmD, Clinical Pharmacist

Here's the thing about Effient (prasugrel): it's a prodrug, meaning it has to be switched on by your body's enzymes before it can keep your platelets from clumping. CYP2C19 is one of several enzymes involved in that activation step, though prasugrel actually relies on it less than some other blood thinners do.

The concern with Boswellia serrata is theoretical, based only on lab-dish (in vitro) research showing it may slow CYP2C19. If it nudged that enzyme down, in theory you could make a touch less of the active drug, which might mean slightly weaker clot protection. Honestly, the real-world evidence here is thin, and I wouldn't lose sleep over it. Still, since Effient protects your heart, check with your pharmacist or doctor before adding boswellia.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Frank A, Unger M. Analysis of frankincense from various Boswellia species with inhibitory activity on human drug metabolising cytochrome P450 enzymes using liquid chromatography mass spectrometry after automated on-line extraction. J Chromatogr A 2006;111 PubMed
Moderate

CYTOCHROME P450 2C9 (CYP2C9) SUBSTRATES

2 of 3

Effient also falls under CYTOCHROME P450 2C9 (CYP2C9) SUBSTRATES.

Theoretically, Boswellia serrata might increase the levels of CYP2C9 substrates.
In vitro research shows that Boswellia serrata gum resin inhibits CYP2C9 enzymes.
Severity Moderate Likelihood Possible Evidence D

Interaction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists.

Dr. Brian Staiger, PharmD, BCPS
Dr. Brian Staiger explains PharmD, Clinical Pharmacist

Here's the thing about Effient (prasugrel): it's a prodrug, meaning your body has to switch it on before it can thin your blood and prevent clots. Several enzymes help with that activation, and CYP2C9 is one of them. Lab studies suggest Boswellia can gently block CYP2C9, so in theory it could slow how much active prasugrel you make, which might make it a little less effective at protecting against clots.

I want to be honest though, this is based only on test-tube research, not on real patients, so we don't truly know if it matters in everyday life. Since prasugrel is keeping you safe after a heart procedure, I wouldn't add boswellia without checking with your pharmacist or cardiologist first.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Frank A, Unger M. Analysis of frankincense from various Boswellia species with inhibitory activity on human drug metabolising cytochrome P450 enzymes using liquid chromatography mass spectrometry after automated on-line extraction. J Chromatogr A 2006;111 PubMed
Moderate

CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES

3 of 3

Effient also falls under CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES.

Theoretically, Boswellia serrata might increase or decrease the levels and clinical effects of CYP3A4 substrates.
In vitro research shows that Boswellia serrata gum resin inhibits CYP3A4 enzymes. Other in vitro research shows that Boswellia serrata extract inhibits CYP3A4 enzymes at most concentrations, although it may modestly induce enzyme activity at low concentrations.
Severity Moderate Likelihood Possible Evidence D

Interaction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists.

Dr. Brian Staiger, PharmD, BCPS
Dr. Brian Staiger explains PharmD, Clinical Pharmacist

Here's the wrinkle with Effient (prasugrel): it's a prodrug, meaning it shows up inactive and your body has to switch it on. Enzymes including CYP3A4 help do that activation. So if Boswellia blocks CYP3A4, the theory is you might activate a little less of the drug, which could slightly soften its clot-preventing punch. On the flip side, in low amounts Boswellia might mildly speed that enzyme up, nudging the effect the other way.

Honestly, this is all based on lab-dish studies, not real people, so it's quite theoretical and the direction isn't even settled. Still, Effient is serious medicine guarding against heart attack and stroke, so don't gamble. Just run your Boswellia plan past your pharmacist or doctor first.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Frank A, Unger M. Analysis of frankincense from various Boswellia species with inhibitory activity on human drug metabolising cytochrome P450 enzymes using liquid chromatography mass spectrometry after automated on-line extraction. J Chromatogr A 2006;111 PubMed
  2. Haron MH, Dale O, Martin K, et al. Evaluation of the Herb-Drug Interaction Potential of Commonly Used Botanicals on the US Market with Regard to PXR- and AhR-Mediated Influences on CYP3A4 and CYP1A2. J Diet Suppl 2022. PubMed

What These Ratings Mean

Every interaction above is graded three ways — here’s the key to each label.

Severity how clinically significant the interaction is
Major

Clinically significant. Avoid the combination, or use only under close professional supervision.

Moderate

Usually worth avoiding or managing — may need monitoring, a dose change, or timing apart.

Minor

Generally not serious. Be aware of it and mention it to your pharmacist.

Likelihood how strong the evidence is that the interaction actually happens in people
  • LikelyWell-controlled human studies have demonstrated the likely existence of this interaction.
  • ProbableInteraction has not been documented in well-controlled studies, however, the interaction has been demonstrated in some small human studies or in controlled animal studies in conjunction with multiple case reports.
  • PossibleInteraction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists.
  • UnlikelyInteraction has been demonstrated in animal or in lab research but has been shown not to occur in humans.
Evidence the quality of the studies behind the rating (graded A–D)
  • AHigh-quality meta-analysis (quantitative systematic review).
  • BCase-control study.
  • CConsensus.
  • DAnecdotal evidence.

These ratings are for information only. Never start, stop, or otherwise change your therapy before speaking with your provider.

Keep it in perspective

Boswellia Serrata Also Interacts With Other Medications

Boswellia Serrata has 951 moderate known drug interactions in our database — the Effient one above is among them. If you take anything else, check it against the full list below.

Moderate 951 No known interaction 1,879 (incl. Effient)
Taking anything else?

Check Another of Your Medications Against Boswellia Serrata

Covers the 2,830 medications we’ve checked against Boswellia Serrata. Pick one to open its full report.

From our Q&A

Questions About Boswellia Serrata or Effient

These are real questions from readers, answered by the pharmacists at HelloPharmacist — written by a person, not generated from a database. Each one covers Boswellia Serrata or Effient, not necessarily both, but if one is close to what you were about to ask it will usually go further than a database entry can:

Not quite your question? Ask our pharmacists directly — it is free, there is no account required, and answers usually come back within 24 hours.

Everything else you take

See Every Supplement That Interacts With Effient

This page covers Boswellia Serrata only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Effient page lists 295 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), Danshen (major), Grapefruit (major), Piracetam (major) and St. John's Wort (major).

By severity: 5 major · 248 moderate · 42 minor.

From our pharmacist’s overview on the Effient page

“Effient (prasugrel) keeps platelets from forming clots, usually after a stent or a heart attack, and I would not pair supplements with it casually. Roughly 200 ingredients on this list can thin the blood further and raise bleeding risk, including two of the five rated major.”

Reviewed by 2 · Jul 18, 2026

Open the Effient interaction page

One more smart check

Taking Boswellia Serrata as Part of a Dietary Supplement Product? Check It for Interactions

We hold 1,914 real supplement products containing Boswellia Serrata, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Boswellia Serrata. Your product may carry other ingredients that interact with Effient too, on top of Boswellia Serrata — and those would not show on this page. Find your product and we’ll check every ingredient on its label:

How much people look this up

Where Boswellia Serrata and Effient Sit Against Everything Else

Out of every supplement and medication people look up on HelloPharmacist, here is where these two land this week — and which way each has been moving.

Supplement Boswellia Serrata
Top 10%

#93 of 1,452 supplements looked up here in the last 7 days

29 days ago today
Medication Effient
Top half

#815 of 2,830 medications looked up here in the last 7 days

29 days ago today

Position among everything looked up on this site, not a measure of how commonly either one is used or how important it is. A supplement can climb this list because of a news story. It counts every request to the page, automated ones included, and nothing here identifies anyone.

Supplement

About Boswellia Serrata

What is Boswellia Serrata?

Boswellia Serrata
  • Osteoarthritis joint pain
  • Rheumatoid arthritis
  • Inflammation
  • Asthma
  • Inflammatory bowel conditions

Boswellia serrata is a tree resin used in traditional medicine, mainly for joint pain and inflammation. Some studies suggest it may help with osteoarthritis symptoms, but the overall evidence is limited and more research is needed. It is generally well tolerated, but you should check with your pharmacist or doctor before using it, especially during pregnancy or breastfeeding.

Read the full Boswellia Serrata monograph & all interactions
Medication

About Prasugrel

What Is Prasugrel Used For?

Brand name: Prasugrel

Prasugrel tablets (brand names Effient and Prasugrel) are used to lower the risk of dangerous blood clots — including clots that can block a stent — in people with acute coronary syndrome (ACS), which includes unstable angina (chest pain at rest) and heart attacks (both NSTEMI and STEMI types). It is used specifically in patients who are being treated with a procedure called percutaneous coronary intervention (PCI), in which a catheter is used to open a blocked coronary artery, often with a stent.

Effient has been shown to reduce the combined rate of cardiovascular death, nonfatal heart attack, or nonfatal stroke compared to clopidogrel — with the benefit driven mainly by fewer heart attacks.

See full Prasugrel drug information
Keep checking

Other Drugs & Boswellia Serrata

Browse every other medication we’ve checked against Boswellia Serrata — both the ones with a known interaction and the ones without. Select any drug for the full detail.

0Major
951Moderate
0Minor
1,878No known interaction
951 Moderate 1,878 No interaction
Moderate

951 interactions

Showing 60 of 951 moderate interactions — see all 951 on the Boswellia Serrata page.

No interaction 1,878 drugs checked — show the list

We also checked Boswellia Serrata against these medications and found no known interaction in our sources. Open any page to confirm.

Showing the 60 most looked-up of 1,878 medications checked with no known interaction — see the full Boswellia Serrata list.

See the full Boswellia Serrata interactions page
See every supplement checked against Effient, ranked by severity
Sources

Sources & How We Checked

Interaction details are evidence-graded and sourced from the Natural Medicines database. The medication overview comes from MedlinePlus.

Content is written and reviewed by licensed HelloPharmacist pharmacists. See our data sources and editorial standards for how this information is built and checked.

Parts of this content are provided by the Therapeutic Research Center, LLC.

DISCLAIMER: Currently this does not check for drug-drug interactions. This is not an all-inclusive comprehensive list of potential interactions and is for informational purposes only. Not all interactions are known or well-reported in the scientific literature, and new interactions are continually being reported. Input is needed from a qualified healthcare provider including a pharmacist before starting any therapy. Application of clinical judgment is necessary.

© 2021 Therapeutic Research Center, LLC

Keep exploring
Boswellia Serrata monograph › Uses, safety, and every drug interaction in one place Effient supplement interactions › Every supplement checked against Effient, ranked by severity Prasugrel drug information › The full plain-English guide to this medication Supplement interaction checker › Check any supplement or product against your medications Browse medications A–Z › Every drug we've checked against herbs & supplements Ask a pharmacist › Free, personal answer from our licensed team
Pharmacist Counseling Corner

Taking Boswellia Serrata and Effient Together: Common Questions

Can you take Boswellia Serrata with Effient?
There is a moderate interaction, so it may be acceptable with monitoring or timing changes — but check with your pharmacist first. Read the full details on this page and confirm with your pharmacist before combining them.
Why are there 3 interactions listed for Boswellia Serrata and Effient?
Effient belongs to more than one drug category, and Boswellia Serrata interacts with each of those categories a little differently. We list every one so nothing is missed — your overall risk is driven by the most serious of them.
How serious is the Boswellia Serrata and Effient interaction?
We rate it Moderate. This combination may require monitoring, a dose adjustment, or separating the times you take each one. Consult your pharmacist before using them together.

Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy

Still Have a Question About Effient and Boswellia Serrata?

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This information is for education only and is not a substitute for professional medical advice. Always check with your pharmacist or doctor before starting, stopping, or combining supplements and medications.